The hospitalization burden of inflammatory bowel disease in a southwestern highland region of China: a territory-wide study from 2015 to 2020

Front Med (Lausanne). 2024 Jun 7:11:1410714. doi: 10.3389/fmed.2024.1410714. eCollection 2024.

Abstract

Background: Yunnan, a southwest highland and newly industrialized region of China, has an unknown hospitalization burden of inflammatory bowel disease (IBD). The study was conducted to explore territorial hospitalization burden of IBD.

Methods: The formatted medical records of patients with IBD were collected from a territory-wide database in Yunnan Province, China, from 2015 to 2020. General characteristics of the study population were reported using descriptive statistics. To evaluate the length of stay, hospitalization costs, surgery, complications, and trends in patients with inflammatory bowel disease. The logistic regression analysis was established to explore the factors affecting the hospitalization costs.

Results: A total of 12,174 records from 8192 patients were included. The annual hospitalization cost of IBD in Yunnan Province increased significantly from 2015 to 2020. From 2015 to 2020, the regional hospitalization burden of IBD increased, but it represented a decline in cost per hospitalization (r = -0.024, P = 0.008) and the length of stay (r = -0.098, P < 0.001). Surgery rates for hospitalized patients with Crohn's disease (CD) did not decrease (r = -0.002, P = 0.932), and even increased for patients with ulcerative colitis (UC) (r = 0.03, P = 0.002). The costs per hospitalization were $ 827.49 (540.11-1295.50) for UC and $ 1057.03 (644.26-1888.78) for CD. Among the identifiable cost items during the period, drug costs accounted for the highest proportion, accounting for 33% and 37.30% in patients with UC and CD, respectively. Surgical intervention [OR 4.87 (3.75-6.31), P < 0.001], comorbidities [OR 1.72 (1.52-1.94), P < 0.001], complications [OR 1.53 (1.32-1.78), P < 0.001], and endoscopy [OR 2.06 (1.86-2.28), P < 0.001] were predictor of high hospitalization costs.

Conclusion: The increasing burden of IBD is noteworthy a newly industrialized region of China. Interventions targeting surgery, complications, and comorbidities may be effective means of controlling the increasing hospitalization costs of IBD in the regions.

Keywords: Crohn’s disease; comorbidities; hospitalization costs; inflammatory bowel disease; ulcerative colitis.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of the article. This work was supported by the National Natural Science Foundation of China (81960108, 82170550, 82160107, and 82260108); Applied Basic Research Projects of Yunnan Province (202201AY070001-086); Basic Research Projects of Yunnan Province (202301AT070131); Yunnan Health Training Project of High-Level Talents (H-2019050); Yunnan Ten Thousand Talents Plan Young and Elite Talents Project; 535 Talent Project of the First Affiliated Hospital of Kunming Medical University (2023535D06 and 2023533Q03).